Automatic association of medical elements

ABSTRACT

An infusion system authorizes changes to operating parameters for a patient by any one of a plurality of caregivers that can be identified as being in a predetermined physical space. Individuals are detected within the space based on detecting signals from respective wireless transmitters associated with the plurality of individuals. Performance of an operation being initiated at the infusion system is authorized based on the identification of the individuals. An association between the operation and the one or more individuals detected within the physical space at a time of the operation is automatically recorded, without requiring a logon of the one or more individuals to the system.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is a continuation application of U.S.application Ser. No. 16/506,914, entitled “AUTOMATIC ASSOCIATION OFMEDICAL ELEMENTS,” filed on Jul. 9, 2019, which is a continuationapplication of U.S. application Ser. No. 15/934,867, entitled “AUTOMATICASSOCIATION OF MEDICAL ELEMENTS,” filed on Mar. 23, 2018, now U.S. Pat.No. 10,347,375, which is a continuation application of U.S. applicationSer. No. 14/337,151, entitled “AUTOMATIC ASSOCIATION OF MEDICALELEMENTS,” filed on Jul. 21, 2014, now U.S. Pat. No. 9,946,837, which isa continuation of U.S. application Ser. No. 12/890,447, entitled“AUTOMATIC ASSOCIATION OF MEDICAL ELEMENTS,” filed on Sep. 24, 2010, nowU.S. Pat. No. 8,786,402, the entirety of each of which is incorporatedherein by reference.

BACKGROUND

The present disclosure generally relates to systems and methods ofidentifying the location of people and equipment, and, in particular,relates to the automatic association of medical equipment with proximatecaregivers and patients

DESCRIPTION OF THE RELATED ART

A commonly followed procedure to ensure the safety of patients beingtreated in hospitals has been the establishment of the “five rights” ofmedication administration. These are (1) right patient, (2) right time,(3) right medication, (4) right route of administration, and (5) rightdose. For a medication administered via an intravenous (IV) pump, forexample, it requires care and attention by the nurse or other caregiverto ensure that the medication matches the patient and that it isadministered at the proper flow rate and the proper time. Patients alsomay receive treatment involving a medical substance other than amedication, e.g. a “normal saline” solution (9 grams of sodium chloride(NaCl) dissolved in 1 liter of water) administered as an infusion totreat dehydration. Maintaining the required level of attention to ensurethat medications and medical substances are properly administered can bea challenge in the hectic environment of a hospital.

Automated processes have been increasingly implemented to reduce thepotential for human error. Scanning a barcode that is printed on awristband worn by a patient, for example, ensures that the patient iscorrectly identified. This type of process, however, often carries apenalty of increased complexity of the process wherein the nurse mustmanually scan one or more barcodes, which also increases the amount oftime required for the nurse to complete a procedure.

SUMMARY

In order to improve the safety of the patient while simultaneouslyeliminating at least some of the time-consuming steps of manuallyscanning barcodes to identify one or more of the patient, the caregiver,the medication, or the medical device, it is advantageous to provide anautomatic association of a patient with the medical device and amedication or other medical substance that are physically proximate tothem. Furthermore, the nurse who is also proximate to the patient can beidentified and associated with the medical device both for determiningthe allowable privileges in configuring the medical device and inrecording the administration of a medication. The combination ofassociating a medical device with a patient, a medication with thepatient and with the medical device, and the caregiver with all of theseelements provides an automatic way to verify the five rights ofmedication administration.

The disclosed method and system provides for the automatic associationof elements that are in or enter a single defined physical space. Theseelements include one or more of a patient, a medical device, amedication or medical substance, and a caregiver. The association ofthese elements enables the automatic configuration of the medical deviceto administer the medication to the patient as well as providing anautomatic record of the caregiver and the details of the administrationof the medication or medical substance.

A method of associating a plurality of objects is disclosed, wherein themethod comprises the steps of defining a physical space, determining byuse of a real time locating system (RTLS) what objects are within thephysical space, and associating the objects determined by the RTLS to bewithin the physical space, wherein the objects include at least one of acaregiver, a patient, a medical device, a medication, and a medicalsubstance.

A method of associating a plurality of objects is disclosed, wherein themethod comprises the steps of defining a physical space about a firstdevice, determining by use of a RTLS objects that are within thephysical space, and associating the objects within the physical spacewith the first device, wherein the objects include at least one of anoperator, a user, a second device, and a supply.

A system is disclosed that includes a RTLS transceiver coupled to aprocessor. The RTLS transceiver is configured to identify and locate oneor more objects having a RTLS tag and provide information comprising theidentification and location of the tagged objects. The processor isconfigured to define a physical space, receive the identification andlocation of the tagged objects, and associate objects that are withinthe physical space.

A computer-readable medium having computer-executable instructionsstored thereon for execution by a processor to perform a method ofassociating a plurality of objects is disclosed, wherein the methodcomprises defining a physical space about a first device, determining byuse of a RTLS what objects are within the physical space, andassociating the objects within the physical space with the first device,wherein the objects include at least one of an operator, a user, asecond device, and a supply.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are included to provide furtherunderstanding and are incorporated in and constitute a part of thisspecification, illustrate disclosed embodiments and together with thedescription serve to explain the principles of the disclosedembodiments. In the drawings:

FIG. 1 depicts an example hospital room where a patient is to receivetreatment according to certain aspects of this disclosure.

FIG. 2 is a plan view of the room of FIG. 1 showing the coverage of anexample RTLS system according to certain aspects of this disclosure.

FIG. 3A is a plan view similar to FIG. 2 where multiple caregivers arepresent within the defined physical space according to certain aspectsof the disclosure.

FIG. 3B is an exemplary display of an IV pump requesting selection ofone of the multiple caregivers present in FIG. 3B according to certainaspects of the disclosure.

FIG. 4 depicts a plan view of a room in which multiple patients arepresent within the defined physical space according to certain aspectsof the disclosure.

FIG. 5 depicts an embodiment wherein the proximity of the elements to beassociated is based on interaction of the individual RTLS tags accordingto certain aspects of the disclosure.

FIG. 6 is a block diagram of an example configuration of the RTLS andthe elements to be associated according to certain aspects of thedisclosure.

FIG. 7 is a flowchart depicting an exemplary process of associatingelements within a defined physical space according to certain aspects ofthe disclosure.

DETAILED DESCRIPTION

The disclosed methods and system provide for the automatic associationof elements that are determined to be within a defined physical space.These elements include one or more of a patient, a medical device, amedication or medical substance, and any nurse, doctor, or othercaregiver. Once these items are associated, one or more of the elementsmay be configured according to the association with other elements,privileges may be granted based on the identification of the caregiverpresent in the physical area, and records kept of actions and eventsthat occur wherein the records include the dedication of the patient,the medical equipment, the medication or medical substance, and theidentities of the caregiver or caregivers that are present in thedefined physical area.

In the following detailed description, numerous specific details are setforth to provide a full understanding of the present disclosure. It willbe apparent, however, to one ordinarily skilled in the art thatembodiments of the present disclosure may be practiced without some ofthe specific details. In other instances, well-known structures andtechniques have not been shown in detail so as not to obscure thedisclosure.

The method and system disclosed herein are presented in terms of theadministration of a medication as an IV fluid using an IV pump to apatient in a hospital. The method and system, however, are equallyapplicable to other medical settings such as an outpatient clinic and tononmedical applications where it is desirable to associate variouselements based on a common presence within a defined physical space.Nothing in this disclosure should be interpreted, unless specificallystated as such, to limit the application of any method or systemdisclosed herein to a medical or hospital environment.

FIG. 1 depicts an example hospital room 18 where a patient 10 is toreceive treatment according to certain aspects of this disclosure. Inthis example, a patient 10 is to receive an infusion of a medication 16using an IV pump 14, wherein this medication 16 is to be administered bya nurse 12. To ensure the safety of the patient, the nurse 12 mustverify that medication 16 has been prescribed for patient 10, ensurethat IV pump 14 is configured to deliver the medication 16 at theprescribed rate, and record all of the details of this medicationadministration in the patient's medication administration record (MAR).Performing these tasks takes time and careful attention and there isalways the risk, even with the most conscientious personnel, of making amistake or forgetting to record something in these manual processes.

FIG. 2 is a plan view of the room of FIG. 1 showing the coverage of anexample RTLS system according to certain aspects of this disclosure. ARTLS identifies objects and tracks the location of the objects in realtime using “tags” that are attached to or embedded in the objects. Thetags comprise wireless transmitters and the RTLS comprises at least onetransceiver that comprises at least one antenna to receive the wirelesssignals from the tags. The transceivers are connected to a centralcontroller, e.g. a part of the RTLS system 44 of FIG. 6, over, in somecases, a standard communication network such as a wired or wirelessEthernet network 50. The central controller comprises a processor thatcontrols the function of the transceivers and stores, e.g. in database44 of FIG. 6, the locations of all objects that have RTLS tags and arewithin the range of at least one transceiver. In some cases, thetransceivers communicate wirelessly between each other to form a meshnetwork that links to the central controller. The range of the antennaof each transceiver defines a physical space, e.g. the physical space 22of FIG. 2, such that an object is known to be within the physical spacewhen the transceiver are able to receive the wireless signal transmittedby the tag that is attached to the object. In some RTLS systems, thelocation of the object within the space can be further determined usingthe signal strength measured by the transceiver or, if the physicalspaces associated with multiple transceivers overlap, receipt of thetag's signal by multiple transceivers. RTLSs may be purchased fromcompanies such as the Awarepoint Corp. of San Diego, Calif., USA andCentrak of Newtown, Pa., USA.

RTLS tags may be generic, wherein all objects of a certain type havetags that are indistinguishable from each other, or specific, whereineach tag has a unique identifier that is part of the wireless signalbroadcast by the tag. For example, a tag that is attached to an IV pump14 may be programmed to either broadcast a code associated with all IVpumps (generic) or broadcast the serial number of that IV pump 14(specific). Similarly, a tag that is embedded in the identification (ID)badge of a nurse 12 may broadcast the ID number assigned to that nurse12 (specific). A tag that is attached to a medicine, for example, suchas an IV bag 16 containing a custom mixture of medications may broadcastthe unique serial number of that specific IV bag 16 (specific). Sometags broadcast a unique identifier that is associated with the tag,wherein the tag identifier is associated in the database 48 with theobject to which the tag is attached, the association of the tagidentifier with the object being made when the tag was attached to theobject. It will be apparent to those of ordinary skill in the art that aRTLS tag may be associated with the object to which the tag is attachedin many other ways.

RTLS tags typically broadcast their signal at intervals that may rangefrom a few seconds to a few minutes. When a tag first enters a physicalspace and the signal broadcast by the tag is detected by the transceiverassociated with that space, the presence of the object associated withthat tag in that physical space is recorded in the database. When a tagis no longer detected by the receiver associated with the physical spacein which it was previously detected, or when the tag is detected to bein a new physical space, the location information stored in the databaseis updated. Thus, the location of all objects that carry RTLS tags areknown on a near-real-time basis, wherein the latency, i.e. the delaybetween a change in location and the change being recorded in thedatabase, is determined in part by the time interval between broadcastsby the RTLS tags.

In the example of FIG. 2, a RTLS transceiver 20 is mounted on a wall 19of a patient room 18, wherein the RTLS transceiver 20 has a range thatdefines a physical space 22 (shown as the shaded region in FIG. 2)wherein the RTLS transceiver 20 is able to communicate with RTLS tags.The physical space covers a portion of the room 18 that includes thepatient bed 11. The range of the RTLS transceiver 20 is such that, inthis example, it does not extend out the door 18A. The patient 10,currently lying in bed 11, is wearing a RTLS tag 10A that is, in thisexample, part of his patient identification wristband. The nurse 12 iswearing a RTLS tag 12A as part of her ID badge. The IV pump 14 has aRTLS tag 14A attached to it. The IV bag of medication 16 also has a RTLStag 16A attached to it. All of the tags 10A, 12A, 14A, and 16A arewithin the defined physical space 22 in FIG. 2.

Multiple associations can be made of objects within the defined physicalspace 22. In this example, the patient was alone in the room 18 prior tothe arrival of the nurse 12 with the IV pump 14 and the medication 16.The defined physical space 22 was therefore first associated withpatient 10. When the nurse 12 arrived with the IV pump 14 and medication16, the IV pump 14 was associated with patient 10, the medication 16 wasassociated with both the patient 10 and the IV pump 14, and the nurse 12was associated with the IV pump 14 to enable the IV pump 14 to beconfigured according to the privileges assigned to nurse 12.

When an IV pump 14 has been associated with a patient 10, additionalsafeguards and automatic actions become possible. For example, if thepatient 10 who is associated with the IV pump 14 becomes separated fromthe IV pump 14, the nurse 12 assigned to the patient 10 can be notifiedto immediately check on the patient 10. Similarly, if a change in one ofthe operating parameters of the IV pump 14 occurs when no caregiver isproximate to the IV pump 14, the nurse 12 assigned to the patient 10 canbe notified to immediately check on the settings of the IV pump 14.

The detection and identification of all of the caregivers that arewithin the defined physical space 22 when an action occurs allowscertain actions to be taken without first requiring the caregiver to logonto the medical device 14. For example, conventional medical devicessometimes require the caregiver to type in their password or otherwiseidentify themselves prior to the caregiver being able to silence analarm. This is both time-consuming, at a time when the caregiver isfocused on correcting a condition for which the alarm sounded, andstressful, as it may be difficult to correctly type a password while analarm is sounding at close range. The disclosed system overcomes thesedifficulties by enabling the alarm to be canceled when a caregiver 12 iswithin the same defined physical space 22 as the medical device 14. Incertain embodiments, the caregiver 12 can walk into a room 18 and, asthe caregiver 12 will be associated with the medical device 14 by thetime the caregiver 12 reaches the medical device 14, the caregiver 12may simply press the button on the medical device 14 to deactivate thealarm without any preliminary action.

FIG. 3A is a plan view similar to FIG. 2 where multiple caregivers arepresent within the defined physical space according to certain aspectsof the disclosure. In this example, the patient 10 and nurse 12 havebeen joined in room 18 by doctors 24 and 26. The nurse 12 and doctors24,26 are all standing within the defined physical space 22. In thisexample, the doctors 24,26 have been assigned privileges related to theIV pump 14 that are greater than the privileges assigned to nurse 12.For example, the doctors 24,26 may be assigned the privilege of settingthe flow rate outside of the standard boundaries defined in the hospitalprotocols, while the nurse 12 may only set the flow rate to a valuewithin the standard boundaries. In this example, the IV pump 14 has beenenabled to accept operating parameters according to the highestprivileges of the three caregivers 12,24,26 who are within the definedphysical space 22. A record will be created that includes theidentification of all caregivers 12,24,26 who are within the definedphysical space 22 at the time the operating parameters were adjusted orother events occur. Although the identities of the caregivers 12,24,26are recorded by the disclosed system, it is not recorded by the systemwhich of the caregivers 12,24,26 took the action. What is noted is thepresence of the caregivers 12,24,26 in the defined space 22 when theaction was taken. In certain embodiments, a caregiver 12 must log intothe IV pump 14 before the IV pump 14 will accept operating parameters,and then will accept operating parameters according to the privileges ofthe logged-in caregiver 12. The record will include the identificationof at least the logged-in caregiver 12. In certain other embodiments, acaregiver 12 must simply identify themselves from a list of thecaregivers 12,24,26 that are currently within the defined space 22.

FIG. 3B is an exemplary display of an IV pump 14 requesting selection ofone of the multiple caregivers 12,24,26 present in FIG. 3B according tocertain aspects of the disclosure. The IV pump is coupled, in thisexample, through a wired or wireless communication link, e.g.communication link 52 of FIG. 6, to a server 46 (not shown in FIG. 3B)that is coupled to the RTLS system 44 (not shown in FIG. 3B) asdiscussed in more detail in FIG. 6. In this example, it is necessary toidentify a specific clinician who has taken an action for the purpose ofrecord-keeping. To this end, a message is sent from the server 46 to theIV pump 14 containing the identification of the caregivers 12,24,26 whohave been detected to be within the physical space 22. The example IVpump 14 shown in FIG. 3B comprises a graphic display 14B and a series ofbuttons 14C on each side of the display 14B. A list of the threeclinicians 12,24,26 is presented on the display 14B, as shown within thebroken-line oval 60. The display 14B also presents an instructionalmessage as shown within the broken-line oval 62. The clinician to beidentified is selected by pressing the button 14C that is next to theirname. This selection is transmitted back to the server 46 and stored inthe database 48. In certain embodiments, the server verifies that thepatient has a prescription comprising the medication; and downloadsconfiguration information to the medical device according to theprescription. In certain embodiments, a list of medications is presentedwhen more than one medication 16 is determined to be within the definedphysical space 22. In certain embodiments, a list of procedures orprescriptions is presented when more than one prescription has beenfound in the database associated with medication 16 and patient 10 andnot already associated with a device. In certain embodiments, operatingparameters that are associated with a procedure that has been orderedfor the patient are downloaded from the database. In certainembodiments, data records that are associated with a procedure that hasbeen performed for the patient are uploaded from the medical device tothe database.

FIG. 4 depicts an example wherein multiple patients 10 and 28 arepresent within the defined physical space 22 according to certainaspects of the disclosure. In this example, hospital room 18 is sharedby two patients 10 and 28 who are wearing RTLS tags 10A and 28A,respectively. Similar to the example of FIGS. 1 and 2, nurse 12 ispreparing to administer medication 16 to patient 10 using IV pump 14.Both patient 10 and patient 28 and their RTLS tags 10A and 28A, however,are within the defined physical space 22. It is not possible todetermine solely from their presence within defined physical space 22which patient is to receive the medication 16. In this example, however,there is a prescription for the administration of medication 16 topatient 10 while there is no such prescription for administration ofmedication 16 to patient 28. Medication 16 has therefore been associatedwith patient 10. This association is presented on the display of IV pump14 for verification by the nurse 12. In certain embodiments, the nurse12 is presented with a display on IV pump 14 of the names of the twopatients 10 and 28, similar to the presentation of the names of themultiple clinicians 12,24,26 on the IV pump 14 in FIG. 3B, and the nurse12 chooses the name of the patient 10 who will receive the medication16. It is faster and less susceptible to error to select from a shortlist of patients rather than search the entire roster of patients in thehospital. In certain embodiments, the patient 10 remains associated withIV pump 14 until the IV pump 14 is reassigned or another specified eventoccurs, such as a discharge of the patient, that has been defined tobreak the association of the IV pump 14 and the patient 10.

FIG. 5 depicts an embodiment wherein the proximity of the elements to beassociated is based on interaction of the individual RTLS tags accordingto certain aspects of the disclosure. In this example, the RTLS tagsinteract among themselves to determine what elements are within closeproximity of each other. Each tag has a limited range. For example, theRTLS tag 10A worn by patient 10 has a range indicated by the broken linecircle 10B. Similarly, RTLS tag 12A worn by nurse 12 has a range 12B,RTLS tag 14A on IV pump 14 has a range of 14B, and RTLS tag 16A attachedto medication 16 has a range 16B. It can be seen that these four rangesoverlap within the area 30 indicated by the thicker dot-dash line.Associations are made between elements within this common area 30enabling certain actions, such as IV pump 14 retrieving the privilegesof nurse 12 based solely on their proximity and prior to any action bynurse 12. Similarly, the proximity of medication 16 and patient 10triggers the retrieval of any prescription for patient 10 that includesthe administration of medication 16.

FIG. 6 is a block diagram of an example configuration of the RTLS andthe elements to be associated according to certain aspects of thedisclosure. In this example, an association system 45 has been createdcomprising a RTLS system 44 and a server 46. The server 46 includes adatabase 48 that contains information about medications prescribed forpatients in the hospital, the privileges of the staff within thehospital, and operating parameters for medical devices within thehospital. In this example, the defined physical space 22 contains onepatient 10 wearing a RTLS tag 10A, a caregiver 12 wearing a RTLS tag12A, a medical device 40 having an attached RTLS tag 40A, and amedication 42 having an attached RTLS tag 42A. This physical space 22may be a fixed location, such as the interior of a hospital room, or maybe a dynamic area surrounding a specific device. For example, a physicalspace 22 may be defined as centered on the current location of medicaldevice 40, wherein the defined physical space 22 moves with the medicaldevice 40. The medical device 40 may be any device used to diagnose ortreat the patient 10 that is also within the defined physical space 22,such as an electrocardiogram (EKG) measurement system, a ventilator, ora simple ear thermometer, as well as an IV pump 14 as shown in theprevious figures. The medication 42, presented in the earlier examplesas a medical fluid, may be any type of medication including oral solids,ointments, or a gas such as oxygen. A RTLS tag present within definedphysical space 22 communicates wirelessly with the RTLS system 44 suchthat the RTLS system 44 determines that the object having an attachedRTLS tag, wherein the RTLS tag has been previously associated with theobject, is within the defined physical space 22. The RTLS system 44communicates with server 46 over a data link 50 such as an Ethernetnetwork. Server 46 is also connected, in this example directly tomedical device 40 over a data link 52, which may be the same Ethernetnetwork as data link 50 or a separate wired or wireless network ordirect connection allowing server 46 to communicate with medical device40. Server 46 can, for example, download operational parameters fromdatabase 48 to medical device 40 and receive information from medicaldevice 40 regarding caregivers that are in proximity to medical device40 when certain actions or events occurred. Server 46 is also connectedto other systems through an internal and/or external network shown as a“cloud” 99. The other systems may include the hospital'sAdmit/Discharge/Transfer (ADT) system, a MAR system, a billing system,and portable devices carried by the doctors or nurses. The connection ofthe RTLS system 44 to the server 46 may be over the Internet or othernetworks, for example.

FIG. 7 is a flowchart depicting an exemplary process of associatingelements within a defined physical space according to certain aspects ofthe disclosure. The process starts in step 105 wherein a physical spaceis defined. This physical space may be a fixed area or may be a dynamicarea linked to an object such as a medical device. Once a physical spaceis defined, the process proceeds to determine whether one or more of apatient, a medical device, a caregiver, or a medication or medicalsubstance is present within the defined physical space in steps 110,115, 120, 125, and 130. If multiple caregivers are present within thedefined physical space and it is necessary to identify the specificcaregiver, for example, when the hospital protocol requires theidentification of the individual performing a specific action or as partof a medication administration record, a list of the caregivers locatedwithin the defined physical space is presented on, for example, adisplay of the medical device, a computer terminal located in the room,or a portable device carried by one of the caregivers in step 135. Thename of the specific individual can be selected in step 140 by one ofthe caregivers using the same device that displays the list. In step145, the privileges associated with all of the caregivers that arepresent within the defined physical space are retrieved and the medicaldevice is configured to accept input based on the highest privileges ofany of the caregivers that are present within the defined physicalspace. In certain embodiments, the caregiver wishing to configure themedical device must identify himself or herself such as by entering apassword whereupon the medical device is configured to accept inputbased on the privileges of that logged-in caregiver. If multiplepatients are present within the defined physical space and it isnecessary to identify the specific patient, for example when amedication is to be administered, then a list of patients within thedefined physical space is presented (on the same device as used in step135) in step 150 and the patient is selected by one of the caregivers instep 155. Other similar sets of steps (not shown) are used to identify aspecific medical device when multiple medical devices are present withinthe defined physical space and to identify a specific medication whenmultiple medications are present within the defined physical space. Oncea medical device and a specific patient have been identified, theprocess proceeds to step 160 wherein the medical device is associatedwith the patient.

Once the medical device is associated with the patient in step 160,configuration information is retrieved from the database in step 165,wherein the configuration information is associated with at least one ofthe medication and the medical device that have been determined to bewithin the defined physical space. In certain embodiments thisconfiguration information includes the operating parameters for themedical device which are downloaded into the medical device directly. Instep 170, the caregiver configures the medical device including physicalconfiguration such as connecting an IV set to a source of medical fluidand to the patient and to the medical device as well as adjustingoperating parameters of the medical device. In step 175, theconfiguration and settings and the identification of all of thecaregivers that have been determined to be within the defined physicalspace are recorded in the patient's MAR. In step 180, the medical deviceis activated and the administration of the medication is initiated. Theprocess stays in step 180 for the duration of the administration ofmedication and the system records a specified list of events and actionsalong with the identification of caregivers that are determined to bewithin the defined physical space at the time the events occur. When theadministration of the medication is complete, the process ends.

In summary, the disclosed method and system of associating one or moreof a patient, a medical device, a caregiver, and a medication or medicalsubstance provides increased patient safety as well as reducing theworkload of the caregiver by implementing configuration changes ordocumentation that otherwise would be manually accomplished. Theautomatic association of a patient with a medication when the medicationis brought into a defined physical space around the patient and enablesthe automatic verification that this is the right patient, the rightmedication, and the right time, covering three of the “five rights” ofmedication administration. Automatic association of a medical device,such as an IV pump, with a patient facilitates the verification thatthis is the right route of administration and enables the automaticdownload of the operating parameters for the medical device, ensuringthat the right dose is administered, addressing the remaining two of the“five rights.” The automatic association of the caregiver with themedical device enables the automatic logging of events along with theidentification of the caregivers that are present, thus reducing theworkload of the caregivers. Furthermore, the automatic logging providesthe facility with greater data for analysis and improved record-keepingand documentation of actual patient care.

The previous description is provided to enable a person of ordinaryskill in the art to practice the various aspects described herein. Whilethe foregoing has described what are considered to be the best modeand/or other examples, it is understood that various modifications tothese aspects will be readily apparent to those skilled in the art, andthe generic principles defined herein may be applied to other aspects.Thus, the claims are not intended to be limited to the aspects shownherein, but is to be accorded the full scope consistent with thelanguage claims, wherein reference to an element in the singular is notintended to mean “one and only one” unless specifically so stated, butrather “one or more.” Unless specifically stated otherwise, the terms “aset” and “some” refer to one or more. Pronouns in the masculine (e.g.,his) include the feminine and neuter gender (e.g., her and its) and viceversa. Headings and subheadings, if any, are used for convenience onlyand do not limit the invention.

It is understood that the specific order or hierarchy of steps in theprocesses disclosed is an illustration of exemplary approaches. Basedupon design preferences, it is understood that the specific order orhierarchy of steps in the processes may be rearranged. Some of the stepsmay be performed simultaneously. The accompanying method claims presentelements of the various steps in a sample order, and are not meant to belimited to the specific order or hierarchy presented.

Terms such as “top,” “bottom,” “front,” “rear” and the like as used inthis disclosure should be understood as referring to an arbitrary frameof reference, rather than to the ordinary gravitational frame ofreference. Thus, a top surface, a bottom surface, a front surface, and arear surface may extend upwardly, downwardly, diagonally, orhorizontally in a gravitational frame of reference.

A phrase such as an “aspect” does not imply that such aspect isessential to the subject technology or that such aspect applies to allconfigurations of the subject technology. A disclosure relating to anaspect may apply to all configurations, or one or more configurations. Aphrase such as an aspect may refer to one or more aspects and viceversa. A phrase such as an “embodiment” does not imply that suchembodiment is essential to the subject technology or that suchembodiment applies to all configurations of the subject technology. Adisclosure relating to an embodiment may apply to all embodiments, orone or more embodiments. A phrase such an embodiment may refer to one ormore embodiments and vice versa.

The word “exemplary” is used herein to mean “serving as an example orillustration.” Any aspect or design described herein as “exemplary” isnot necessarily to be construed as preferred or advantageous over otheraspects or designs.

All structural and functional equivalents to the elements of the variousaspects described throughout this disclosure that are known or latercome to be known to those of ordinary skill in the art are expresslyincorporated herein by reference and are intended to be encompassed bythe claims. Moreover, nothing disclosed herein is intended to bededicated to the public regardless of whether such disclosure isexplicitly recited in the claims. No claim element is to be construedunder the provisions of 35 U.S.C. § 112, sixth paragraph, unless theelement is expressly recited using the phrase “means for” or, in thecase of a method claim, the element is recited using the phrase “stepfor.” Furthermore, to the extent that the term “include,” “have,” or thelike is used in the description or the claims, such term is intended tobe inclusive in a manner similar to the term “comprise” as “comprise” isinterpreted when employed as a transitional word in a claim.

What is claimed is:
 1. An infusion device configured to: identify one ormore caregivers within a physical area associated with the infusiondevice without receiving a logon of the one or more caregivers at theinfusion device based on a detection, by one or more receiving devicesassociated with the infusion device, of one or more wireless transmittersignals associated with the one or more caregivers; receive anindication of an operation initiated at the infusion device withoutfirst authorizing the one or more caregivers to use the infusion device;authorize performance of the operation, without further userintervention, based on the indication and detecting that the one or morecaregivers are within the physical area associated with the infusiondevice; and automatically record, responsive to authorizing theperformance of the operation, an association between the operation andthe one or more caregivers detected within the physical area at a timeof the operation, without receiving a logon of the one or morecaregivers at the infusion device.
 2. The infusion device of claim 1,wherein a plurality of caregivers are identified in the physical area,and wherein the performance of the operation is authorized according tothe highest privileges of the plurality of caregivers identified withinthe physical area at a time the operation is initiated, and wherein theassociation between the operation and the one or more caregiversincludes an association between the operation and the plurality ofcaregivers in the physical area at the time the operation is initiated.3. The infusion device of claim 1, wherein a plurality of caregivers areidentified in the physical area, and wherein each caregiver of theplurality of caregivers is assigned a privilege level related to theinfusion device, and wherein the infusion device is further configuredto: receive, before authorizing performance of the operation, anidentification of a first caregiver having a privilege level notsatisfying a threshold for authorizing the performance of the operation,wherein a second caregiver of the plurality of caregivers has aprivilege level that satisfies the threshold; wherein the performance ofthe operation is authorized according to the privilege level of thesecond caregiver, and wherein the association between the operation andthe one or more caregivers includes an association between the operationand the plurality of caregivers in the physical area at a time theoperation is initiated.
 4. The infusion device of claim 3, wherein theprivilege level of the first caregiver only authorizes changes tooperating parameters that are within predetermined limits on theoperating parameters, and the privilege level of the second caregiverauthorizes changes to the operating parameters that are outside of thepredetermined limits.
 5. The infusion device of claim 1, wherein theinfusion device is further configured to: provide, for display on adisplay screen associated with the infusion device, a listing of the oneor more caregivers detected by the one or more receiving devices, beforeauthorizing performance of the operation; and receive a selection of arespective caregiver of the one or more caregivers; and record therespective caregiver as a caregiver who performed the operation.
 6. Theinfusion device of claim 1, wherein the operation initiated at theinfusion device comprises an adjustment to one or more operatingparameters of the infusion device.
 7. The infusion device of claim 1,wherein the infusion device is further configured to: identify amedication within the physical area associated with the infusion devicebased on a wireless transmitter associated with the medication beingdetected by the one or more receiving devices; and automaticallyprogram, based on identifying the medication within the physical area,the infusion device with one or more operating parameters associatedwith administering the medication, wherein the association between theoperation and the one or more caregivers includes an association betweenthe operation, the one or more caregivers, and the medication.
 8. Theinfusion device of claim 7, wherein the infusion device is furtherconfigured to: identify a patient within the physical area associatedwith the infusion device based on a wireless transmitter associated withthe patient being detected by the one or more receiving devices; andautomatically associate, based on identifying the medication within thephysical area, the infusion device with the patient, wherein theassociation between the operation and the one or more caregiversincludes an association between the operation, the one or morecaregivers, the medication, and the patient.
 9. The infusion device ofclaim 8, wherein the infusion device is further configured to: identifyan electronic prescription associated with the patient; compare theidentified medication with the identified electronic prescription; andverify, based on comparing the identified medication with the identifiedelectronic prescription, that the identified medication is for thepatient prior to authorizing performance of the operation by theinfusion device.
 10. The infusion device of claim 1, wherein theinfusion device is further configured to: identify a plurality ofpatients within the physical area associated with the infusion devicebased on respective wireless transmitters associated with the pluralityof patients being detected by the one or more receiving devices;provide, for display on a display screen associated with the infusiondevice, a listing of the plurality of patients detected by the one ormore receiving devices, before authorizing performance of the operation;receive, from the listing, a selection of a respective patient;associate the respective patient with the infusion device; and confirmthat a medication has been ordered for the selected patient beforeauthorizing performance of the operation.
 11. A computer-implementedmethod comprising, under the control of one or more electronic devices:receiving, from one or more receiving devices associated with aninfusion device, one or more wireless signals associated with one ormore caregivers within a physical area associated with the infusiondevice, without receiving a logon to the infusion device from the one ormore caregivers; identifying the one or more caregivers based at leastin part on the one or more wireless transmitter signals associated withthe one or more caregivers; receiving an indication of an operationinitiated at the infusion device without first authorizing the one ormore caregivers to use the infusion device; authorizing performance ofthe operation, without further user intervention, based on theindication and detecting that the one or more caregivers are within thephysical area associated with the infusion device; and automaticallyrecording, responsive to authorizing the performance of the operation,an association between the operation and the one or more caregiversdetected within the physical area at a time of the operation, withoutreceiving a logon of the one or more caregivers at the infusion device.12. The method of claim 11, wherein a plurality of caregivers areidentified in the physical area, and wherein the performance of theoperation is authorized according to the highest privileges of theplurality of caregivers identified within the physical area at a timethe operation is initiated, and wherein the association between theoperation and the one or more caregivers includes an association betweenthe operation and the plurality of caregivers in the physical area atthe time the operation is initiated.
 13. The method of claim 11, whereina plurality of caregivers are identified in the physical area, andwherein each caregiver of the plurality of caregivers is assigned aprivilege level related to the infusion device, and wherein the methodfurther comprises: receiving, before authorizing performance of theoperation, an identification of a first caregiver having a privilegelevel not satisfying a threshold for authorizing the performance of theoperation, wherein a second caregiver of the plurality of caregivers hasa privilege level that satisfies the threshold, wherein the performanceof the operation is authorized according to the privilege level of thesecond caregiver, and wherein the association between the operation andthe one or more caregivers includes an association between the operationand the plurality of caregivers in the physical area at a time theoperation is initiated.
 14. The method of claim 13, wherein theprivilege level of the first caregiver only authorizes changes tooperating parameters that are within predetermined limits on theoperating parameters, and the privilege level of the second caregiverauthorizes changes to the operating parameters that are outside of thepredetermined limits.
 15. The method of claim 11, further comprising:providing, for display on a display screen associated with the infusiondevice, a listing of the one or more caregivers detected by the one ormore receiving devices, before authorizing performance of the operation;and receiving a selection of a respective caregiver; and recording therespective caregiver as a caregiver who performed the operation.
 16. Themethod of claim 11, wherein the operation initiated at the infusiondevice comprises an adjustment to one or more operating parameters ofthe infusion device.
 17. The method of claim 11, further comprising:identifying a medication within the physical area associated with theinfusion device based on a wireless transmitter associated with themedication being detected by the one or more receiving devices; andautomatically programming, based on identifying the medication withinthe physical area, the infusion device with one or more operatingparameters associated with administering the medication, wherein theassociation between the operation and the one or more caregiversincludes an association between the operation, the one or morecaregivers, and the medication.
 18. The method of claim 17, furthercomprising: identifying a patient within the physical area associatedwith the infusion device based on a wireless transmitter associated withthe patient being detected by the one or more receiving devices; andautomatically associating, based on identifying the medication withinthe physical area, the infusion device with the patient, wherein theassociation between the operation and the one or more caregiversincludes an association between the operation, the one or morecaregivers, the medication, and the patient.
 19. The method of claim 18,further comprising: identifying an electronic prescription associatedwith the patient; verifying, based on a comparison of the identifiedmedication with the identified electronic prescription, that theidentified medication is for the patient prior to authorizingperformance of the operation by the infusion device.
 20. The method ofclaim 11, further comprising: identifying a plurality of patients withinthe physical area associated with the infusion device based onrespective wireless transmitters associated with the plurality ofpatients being detected by the one or more receiving devices; providing,for display on a display screen associated with the infusion device, alisting of the plurality of patients detected by the one or morereceiving devices, before authorizing performance of the operation;receiving, from the listing, a selection of a respective patient;associating the respective patient with the infusion device; andconfirming that a medication has been ordered for the selected patientbefore authorizing performance of the operation.